Assessment of cardiomyopathy

Last reviewed: 1 Apr 2025
Last updated: 02 Apr 2025

Summary

Differentials

Common

  • Idiopathic dilated cardiomyopathy
  • Myocarditis
  • Alcohol: dilated cardiomyopathy
Full details

Uncommon

  • Hypertrophic cardiomyopathy (HCM)
  • Idiopathic restrictive cardiomyopathy
  • Arrhythmogenic right ventricular cardiomyopathy (ARVC)
  • Brugada syndrome and other ion channelopathies
  • Conduction system disease
  • Mitochondrial disorders
  • Takotsubo syndrome
  • Peripartum: dilated cardiomyopathy
  • Tachycardia-induced: dilated cardiomyopathy
  • Amyloidosis: hypertrophic or restrictive cardiomyopathy
  • Haemochromatosis: restrictive or dilated cardiomyopathy
  • Fabry disease: hypertrophic or restrictive cardiomyopathy
  • Other lysosomal storage disease
  • Doxorubicin: dilated cardiomyopathy
  • Heavy metals/chemicals: dilated cardiomyopathy
  • Diabetes mellitus
  • Thyroid dysfunction: dilated cardiomyopathy
  • Acromegaly: hypertrophic or dilated cardiomyopathy
  • Noonan syndrome: hypertrophic cardiomyopathy
  • Lentiginosis: hypertrophic cardiomyopathy
  • Thiamine deficiency (wet beriberi): dilated cardiomyopathy
  • Friedreich's ataxia/muscular dystrophy: hypertrophic and dilated cardiomyopathy
  • Deficiency of iron, niacin, selenium, or vitamin D: dilated cardiomyopathy
  • Systemic lupus erythematosus: dilated cardiomyopathy
  • Endomyocardial fibrosis/Loeffler endocarditis (hypereosinophilic syndrome)
  • Sarcoidosis
  • Electrolyte disorders
Full details

Contributors

Authors

Katie Linden, BMSc, MBChB

Cardiology Specialty Registrar

Belfast Health and Social Care Trust

Belfast

Northern Ireland

Disclosures

KL was reimbursed by Takeda UK Ltd., the manufacturer of Replagal for Fabry disease, for travel and accommodation for a leadership course. KL was reimbursed by Sanofi Aventis, the manufacturer of Genzyme for Fabry disease, for travel and accommodation for a conference. KL received a speaker fee from Sanofi Aventis, the manufacturer of Genzyme, for a talk on Fabry disease. There was no contractual right by Sanofi to control the content of this talk.

Alison Muir, MD

Consultant Cardiologist

Royal Victoria Hospital

Belfast Health and Social Care Trust

Belfast

UK

Disclosures

AM is an author of a reference cited in this topic.

Acknowledgements

KL and AM would like to gratefully acknowledge Dr Pascal McKeown, a previous contributor to this topic. PM is an author of a reference cited in this topic.

Peer reviewers

Lubna Choudhury, MB BCh, MD, MRCPI, FACC

Professor of Medicine

Division of Cardiology

Northwestern University

Chicago

IL

Disclosures

LC declares that she has no competing interests.

John Coltart, MD, FRCP, FACC, FESC, MRCS

Consultant Cardiologist

Cardio-thoracic Unit

Guy's and St Thomas' Hospital

London

UK

Disclosures

JC declares that he has no competing interests.

Vaikom S. Mahadevan, MBBS, MRCP

Consultant Cardiologist

Manchester Royal Infirmary

Manchester

UK

Disclosures

VSM declares that he has no competing interests.

References

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Key articles

Arbelo E, Protonotarios A, Gimeno JR, et al. 2023 ESC guidelines for the management of cardiomyopathies. Eur Heart J. 2023 Oct 1;44(37):3503-626.Full text  Abstract

Ommen SR, Ho CY, Asif IM, et al. 2024 AHA/ACC/AMSSM/HRS/PACES/SCMR guideline for the management of hypertrophic cardiomyopathy: a report of the American Heart Association/American College of Cardiology joint committee on clinical practice guidelines. Circulation. 2024 Jun 4;149(23):e1239-311.Full text  Abstract

Nagueh SF, Phelan D, Abraham T, et al. Recommendations for multimodality cardiovascular imaging of patients with hypertrophic cardiomyopathy: an update from the American Society of Echocardiography, in collaboration with the American Society of Nuclear Cardiology, the Society for Cardiovascular Magnetic Resonance, and the Society of Cardiovascular Computed Tomography. J Am Soc Echocardiogr. 2022 Jun;35(6):533-69.Full text  Abstract

American College of Radiology. ACR appropriateness criteria® Nonischemic myocardial disease with clinical manifestations (ischemic cardiomyopathy already excluded). May 2021 [internet publication].Full text  Abstract

British Society of Echocardiography. Diagnosis and assessment of dilated cardiomyopathy: a guideline protocol from the British Society of Echocardiography. Jun 2017 [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Assessment of cardiomyopathy images
  • Guidelines

    • Management of cardiomyopathies
    • Recommendations for multimodality cardiovascular imaging of patients with hypertrophic cardiomyopathy: an update from the American Society of Echocardiography, in collaboration with the American Society of Nuclear Cardiology, the Society for Cardiovascular Magnetic Resonance, and the Society of Cardiovascular Computed Tomography
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